Q&A: Building a successful case management program

May 15, 2019
Medicare Web

Q: What is the best advice you can give for developing and managing a successful case management program?

A: Case management plays a pivotal role in being both advocate to the organization and ally to the patient and family. A great case management program is built through the lens of the professional (person), process (workflows), and technology offered to support practice.


  • Evaluating clinical skills/mindsets
  • Understanding competencies
  • Review of roles and their clarity
  • Team approach
  • Engagement/values tied to mission/vision


  • Embedded practices that are reliable and evidence-based
  • Integration of practices within teams
  • Efficient workflows
  • Sustainable practices
  • Patient identification and interventions


  • Data that is validated and reliable
  • Data that is actionable
  • Use of EMR for communications and patient identification
  • Use of reports and other data for ongoing decision making
  • Optimization of current technology

As case management leaders and pioneers of the care continuum, we must lead our teams to be visible, viable, and valuable. The discipline of case management continues to evolve and offer solutions for the care continuum in a way that no other profession does because case management is at the nexus of care.

Case managers offer influence as incentive aligners, team players, partners, and community advocates. The discipline of case management embraces cultural change and shared outcomes. It spreads the belief that clinical integration is both essential and the most important way we can lead patients to a safe and effective outcome.

For more information see Care Transitions in Case Management.